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Law and Ethics NURS 3560 > Week 5 End of life/MAiD > Flashcards

Week 5 End of life/MAiD Flashcards

1
Q

What is Manitoba’s definition of death in the vital statistics act?

A

the irreversible cessation of all brain functions - brain death

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2
Q

Is the definition of death federal or provincial?

A

Provincial

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3
Q

What is homicide according to the criminal code of canada?

A

directly or indirectly, by any means, causes the death of a human being

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4
Q

What is withholding treatment?

A

not even starting an intervention

it’s the decision to NOT begin a life sustaining therapy or intervention which could potentially keep a person alive (CPR, TPN)

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5
Q

What is withdrawing treatment?

A

the decision to STOP or CEASE a life sustaining therapy or intervention which is potentially keeping a person alive

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6
Q

Withholding treatment and withdrawing treatment are only legal in which circumstances?

A
  1. Patient is fully informed & competent
  2. SDM is acting on behalf of incapable/incompetent patient that is in their best interest
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7
Q

What is Euthanasia according to the law reform commission of Canada?

A

the act of ending the life of a person
- compassionate motives
- person is already terminally ill
- person’s suffering has become unbearable
- exception is MAiD

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8
Q
A
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9
Q

What is MAiD and what legal code is it under?

A

Criminal Code of Canada
- legal process that allows someone to be assisted by a medical practitioner to end their lif
- must be found eligible for MAiD or it doesn’t count and would be homicide
- an act that directly results in the death of a person
- In Canada , the physician does it - not the patient

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10
Q

what is an example of life-sustaining therapy?

A

dialysis
prolongs life but not curative
- person would need kidney transplant

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11
Q

What is futile care?

A

-many definitions
- life-sustaining or life-prolonging technologies will not help patient have productive life
- remain vegetative state or no benefit to the care
- We may hear it as “person in not a candidate for … ICU (eg)”

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12
Q

what is Advance care planning?

A
  • end of life wishes BEFORE decisions need to be made
  • record of patients wishes
  • can be done with family/friend, health care directive, ACP status (goals of care form)
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13
Q

Which is legal, Advanced care plan or Health care directive and what happens if the legal one is not followed?

A

Health care directive
charge of battery

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14
Q

Which is legally binding but governed by organizational policies, the Health care directive or Goals of Care form?

A

Goals of care form

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15
Q

Can a health care directive be initiated by the health care team?

A

no, must be self -initiated

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16
Q

Can the Health Care directive and the Goals of Care form be completed with the family ?

A

The health care directive must be completed by the individual

the Goals of Care form can be completed with the family if the patient is not longer able to

17
Q

What is a negative right and what two things is it connected to ?

A

a right to be free from something a person doesn’t want

  1. requirment for informed consent
  2. law (battery) and ethics (autonomy)
18
Q

What is a positive right and what are the legalities surrounding this concept?

A

a right to have something
- NOT enshrined in law
- ie) HCP does not have to do something that goes against good practice

19
Q

Which is law, negative right or positive right?

A

negative right - because you can’t do something to someone if they don’t consent. That’s illegal.

20
Q

What is conscientious objection?

A

the refusal to provide legal and professionaly accepted goods or services that fall within the scope of professional competence, on the grounds of conscience
- b/c they are contrary to one’s moral beliefs and values

21
Q

What is the 3 criteria for conscientious objection?

A
  1. nurse has had this belief for a very long time and thinks it is wrong and that it would compromise the nurses’ personal moral integrity
  2. Not urgent or emergent situation
  3. there is another nurse who can assume the care in a timely manner
22
Q

Under the law, what happens if a nurse has a conscientious objection to MAiD?

A

no legal obligation to participate in MAiD
BUT
you can’t abandon your patient !

23
Q

What is the eligibility criteria for MAid?

A
  1. must be a resident and have gov’t funded health services
  2. 18+ and competent
  3. have a grievous + Irremediable medical condition
  4. voluntary - no coersion
  5. informed consent after reviewing all options including palliative care
24
Q

what are the 3 critera for grievous and irremediable medical condition?

A
  1. serious + incurable illness, disease or disability (not mental illness)
  2. be in advanced state of irreversible decline in capability
  3. Have intolerable suffering due to #1 or #2 that can’t be relieved by treatment acceptable to patient
25
Q

What three criteria exclude someone from MAiD?

A
  1. Minors
  2. Advance directive/living will
    - must have illness + competent
  3. mental disorder as sole medical condition (except neurocognitive disorders)
26
Q

what are the two pathways of MAiD?

A

RFND - reasonably foreseeable natural death (track 1) - on a path towards death

NRFND - no reasonably forseeable natural death
- chronic illness that is not life limiting (track 2)

27
Q

What are the safeguards for RFND?

A
  1. written request with witness
  2. 2 assessments
  3. can withdraw request anytime in any manor
  4. opportunity to withdraw request + need to reconfirm consent immediately before receiving MAiD
28
Q

NFRND follows the same track as FRND except includes the following additional safeguards:

A
  1. Mandatory 90 day assessment period
  2. expertise input on condition causing suffering
  3. information on available supports
  4. agreement that patient has given serious consideration to options avaialbe to relieve suffering
29
Q

How long is the assessment period for MAiD under track 2?

A

90 day minimum

30
Q

What is the purpose of patient assessments for MAiD?

A

To determine if all the
1. eligibility criteria
2. safeguards
have been met
3. identify unmet needs that can be addressed

31
Q

Who administers the medications for MAid?

A

the MD/NP who did the assessment

32
Q

What are the 3 medications used in MAiD?

A

Midazolam
propofol
rocuronium

33
Q

What is the health care provider’s role when someone requests MAiD?

A
  1. respond to the request
  2. provide non-MAiD related medical care
  3. timely access to a resource that provides accurate info
  4. provide medical records and documentation as requested
34
Q

What is the foundation of MAiD?

A

autonomy and choice

Law and Ethics NURS 3560 (6 decks)

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